Monday, March 11, 2013

The future of health care is where?

Students who sign up for JRMC 7355, the first of a two-part sequence in health and medical journalism, never quite know what to expect.

Back in 2007, the capstone project was a reporting trip to post-Katrina New Orleans, focused on neighborhood medical homes. Subsequent groups of students have covered the American College of Cardiology and the American Academy of Pediatrics, as well as national gatherings of state and municipal emergency officials and forensic scientists (amazing slides!).

If there is such a thing as a typical year, it involves setting up shop in an outlying North Georgia county and working as a one-person news bureau, digging out news and features related to public health, medicine, the business of healthcare and environmental risks. Teen pregnancy, hospitals up for sale, special drug courts, occupational hazards of granite finishing, even parents who help their kids get drunk. It's all there.

Many of these stories have been published by professional news organizations and you can find these -- and more -- here.

This year students got an even bigger surprise: they are traveling across the country to Reno, NV, to report, writing and produce multimedia stories with national implications.

In fact, we're hoping that some of our friends at AHCJ13 will help roll out these stories nationally over the next six weeks or so.

Here are the basics:

Last summer, the Athens Health Network, a coalition of providers serving uninsured people in the Athens area, voted to establish a system resembling concierge care not for the rich, but for people who build houses, prepare food, play music or care for old folks.

This would dramatically strengthen the safety net for Athens, where about 30 percent of 115,000 residents live in poverty but fall through the cracks of the health care system because they are not eligible for Medicaid and work at jobs with no health benefits.

This model works like Sam's Club: you pay a membership fee and then purchase what you need at deeply discounted prices. In Nevada, a mother with one child (up to age 19) earning between 100 and 199 percent of the federal poverty level would pay $45/month for membership. She would pay $40 for a regular primary care visit, and if hospitalized would be charged $400/day. She would pay $70 to have a wound stitched up at an urgent care center.

This approach, often called a nonprofit medical discount plan, has been operating for the past seven years in Reno, Nevada. Hospitals, clinics, doctors, mental health providers, dentists and vision specialists, public health officials, financial institutions and advocacy groups have joined forces to make preventive health services and acute care available to uninsured working people. Communities throughout Nevada have since adopted the shared-responsibility model for health care and there is evidence that it improves health outcomes and reduces inappropriate care, such as ER visits for non-emergency conditions.

Athens is the first community outside Nevada that has committed to replicating this model.

The challenge for this year's JRMC 7355 students is to document what happens when a group of adventurous healthcare providers see something they like -- all the way across the country in a city glittering with casinos -- and tries to bring it back home.

Is it crazy to think that a desert creature from Nevada can be born again in a state not noted for embracing change?

The reporters are going to find out. They spent the first half of the semester covering problems that the new plan might help solve: low-wage workers and small businesses with no coverage, local hospitals and doctors going unpaid, overburdened mental health services, free clinics struggling for funds and many more.

Now begins their adventure in time travel: whatever difficulties arise in Athens, whatever the objections of local doctors or the worries of hospital administrators, chances are that Reno or other Nevada communities have faced something similar. And dealt with it. Or not.

Armed with database research, notebooks and video cameras, most of the UGA students who'll be at AHCJ this week are already holding E-tickets to Reno. If you have advice, please share it.

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Grady College's Health & Medical Journalism Masters program at University of Georgia prepares reporters to write accurate, timely, interesting and credible articles about health and medical news for various audiences. Basic newswriting skills are required, and it helps to have a spirit of adventure. Students receive hands-on training by exploring and reporting health issues impacting various counties in Northeast Georgia.